Haematological malignancies Flashcards

1
Q

What is the most common malignancy in children?

A

Acute lymphoblastic leukaemia

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2
Q

What are the symptoms of acute leukaemia?

A
1) Symptoms of bone marrow failure 
–  Anaemia
–  Thrombocytopenia (bleeding)
–  Neutropenia (infections)
(Note WBC may be high, normal or low)

2) Symptoms related to tissue infiltration
– Lymphadenopathy
- Hepatosplenomegaly
– Gum hypertrophy
– Rash, subcutaneous chloromas
– CNS involvement (cranial nerve palsies, meningism)

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3
Q

Which type of leukaemia is caused by translocation of bcr-abl?

A

Chronic myeloid leukaemia

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4
Q

What does basophilia suggest the diagnosis is?

A

Chronic myeloid leukaemia

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5
Q

What is the targeted therapy for CML?

A

Glivec/Imatinib (TK inhibitor)

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6
Q

Which cells are usually affected in CLL?

A

B lymphocytes

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7
Q

How are lymphomas categorised histologically?

A

High grade or low grade

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8
Q

Which cancer regularly causes bone lesions?

A

Myeloma

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9
Q

What symptoms may be seen in multiple myeloma?

A
- Fatigue/anaemia
–  Bone pain/pathological fracture 
–  Symptoms of hypercalcaemia
–  Symptoms of hyperviscosity
 –  Renal failure
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10
Q

What kind of lymphoma is Bcl-2 positive?

A

Follicular lymphoma

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11
Q

What are the main dangers of leukaemia?

A

Neutropenia and sepsis
Tumour Lysis Syndrome
Hyperviscosity- leading to leukostasis
DIC

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12
Q

Which leukaemia is associated with myelodysplastic states?

A

AML

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13
Q

What is the 3 year survival for patients with AML, following treatment?

A

20%

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14
Q

Which leukaemia is associated with DIC?

A

Acute promyelocytic leukaemia (a subtype of AML, in which there is a release of thromboplastin)

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15
Q

Auer rods are diagnostic of which leukaemia?

A

AML

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16
Q

What is the commonest leukaemia?

A

CLL

17
Q

What are the 3 complications of CLL

A

1) Autoimmune haemolysis
2) Infection due to hypogammaglobulinaemia.
3) Marrow failure

18
Q

In what kind of blood cancer are Reed-Sternberg cells found?

A

Hodgkin’s lymphoma

19
Q

A stage III B lymphoma, using the Ann Arbor system =?

A

Involvement of LN on both sides of diaphragm and presence of B symptoms.

20
Q

What are the B symptoms?

A

1) Weight loss of >10% over 6 months, unexplaned fever >38deg, drenching night sweats.

21
Q

How is Hodgkin’s lymphoma stage I-A and II-A treated?

A

Radiotherapy +/- short courses of chemotherapy.

22
Q

How are Hodgkin’s lymphoma stage II-A with >3 node) through to IV-B treated?

A

Long course chemotherapy: ABVD

23
Q

What is the commonest NHL?

A

Diffuse Large B Cell Lymphoma (DLBCL)

24
Q

What causes NHL?

A

Immunodeficiency: drugs, HIV (EBV transformed cells), HTLV-1, H.Pylori, toxins, congenital

25
Q

What is Sezary syndrome?

A

A cutaneous T cell lymphoma. Cells have pathological quantities of mucopolysaccharides

26
Q

What patterns of extranodal disease exist in NHL?

A

Skin: T cell lymphomas
Oropharynx: Waldeyer’s ring lymphoma
Gut: 1) Gastric MALT, 2) Non-MALT gastric lymphomas, 3) Small-bowel lymphomas

Other possible sites: lung, bone, CNS

27
Q

Which NH lymphoma has characteristic jaw lymphadenopathy?

A

Burkitt’s lymphoma

28
Q

What treatment regime is used for high grade Non-Hodgkin’s lymphomas?

A

R-CHOP

29
Q

What causes the osteolytic lesions in myeloma?

A

Increased osteoclast activity, due to signalling by myeloma cells

30
Q

In which type of blood cancer do we see rouleaux formation?

A

Myeloma

31
Q

What are the complications of myeloma?

A

1) Hypercalcemia
2) Spinal cord compression
3) Hyperviscosity
4) Acute renal injury